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Smoking Increases Odds of Repeated Suicide Attempt in People With Bipolar Disorder

July 03, 2019

People with bipolar disorder who smoke tobacco, whether or not they have other substance use disorders, are at a higher risk of repeating a suicide attempt, according to a study published in the Journal of Affective Disorders.

“Substance use disorders (SUD) (including tobacco-related) are strongly associated with both bipolar disorder and suicide attempts, however, their specific role for the recurrence of suicide attempts in bipolar disorder remains inadequately investigated,” researchers wrote. “Thus, we tested if tobacco smoking—with or without other SUDs—was independently associated with recurrent suicide attempts in bipolar disorder.”

The investigation, which involved 916 people with bipolar disorder in France and Norway, revealed it was. In fact, current tobacco smoking increased the likelihood of recurrent suicide attempts in participants by 1.75 times, compared with not smoking, Psychiatric News Alert reported.

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Combining tobacco smoking with cannabis use disorder raised the likelihood of recurrent suicide attempts by 2.65 times. Tobacco smoking and alcohol use disorder, meanwhile, boosted the likelihood of recurrent suicide attempts by 3.58 times.

Recurrent suicide attempts were also more common in people who experienced depression rather than mania as their first bipolar disorder symptom as well as in women, independent of smoking status, researchers reported.

“Tobacco smoking with or without additional SUD can be important risk factors of suicide attempt recurrence in bipolar disorder,” researchers concluded, “which is likely to inform both research and prevention strategies.”

—Jolynn Tumolo


Icick R, Melle I, Etain B, et al. Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder. Journal of Affective Disorders. 2019;256: 348-357.

Smoking increases risk of recurrent suicide attempts in patients with bipolar disorder, study finds. Psychiatric News Alert. June 17, 2019.

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